Arthroscopic Bankart Riskier Than Open Latarjet for Young Males

Arthroscopic Bankart operation is significantly riskier when it comes to short-term re-dislocations than open Latarjet in young males being treated for anteroinferior instability, according to a new study.

In the study, “Arthroscopic Bankart versus open Latarjet as a primary operative treatment for traumatic anteroinferior instability in young males: a randomized controlled trial with 2-year follow-up,” published online on September 22, 2021 in the British Journal of Sports Medicine, the researchers compared the outcomes between arthroscopic Bankart repair and open Latarjet in young males.

“Anteroinferior shoulder dislocation is a frequent sports-related trauma, which is often accompanied by labral, ligament and even bony lesions of the glenohumeral joint. In up to 67% of cases, initial conservative treatment fails depending on the age and activity level of the patient,” the researchers wrote.

The authors of the study were:

• Juha Kukkonen, Orthopaedics and Traumatology, Turku University Hospital, Turku, Finland Faculty of Medicine, University of Turku, Turku, Finland
• Sami Elamo Surgery, Division of Orthopaedic and Trauma Surgery, Satakunta Central Hospital, Pori, Finland
• Tapio Flinkkilä Surgery, Division of Orthopaedic and Trauma Surgery, Oulu University Hospital, Oulu, Finland
• Juha Paloneva Orthopaedics and Traumatology, Central Finland Central Hospital Jyvaskyla, Finland
• Miia Mäntysaari Orthopaedics and Traumatology, Helsinki University Hospital, Helsinki, Finland
• Antti Joukainen Orthopaedics and Traumatology, Kuopio University Hospital, Kuopio, Finland
• Janne Lehtinen Orthopaedic Unit, Tays Hatanpää Hospital, Tampere University Hospital, Tampere, Finland
• Vesa Lepola Pohjola Hospital Tampere, Tampere, Finland
• Milja Holstila Department of Radiology, Turku University Hospital, Turku, Finland
• Tommi Kauko Auria Clinical Informatics, Turku University Hospital, Turku, Finland
• Ville Aarimaa Orthopaedics and Traumatology, Turku University Hospital, Turku, Finland, Faculty of Medicine, University of Turku, Turku, Finland.

The multicenter randomized controlled trial was conducted at orthopedic departments in eight public hospitals in Finland and enrolled 91 young males with the mean age 21 years (range 16-25 years) with traumatic shoulder anteroinferior instability.

The primary outcome measure was the reported recurrence of instability or dislocation at 2-year follow-up. The secondary outcome measures included clinical apprehension, sports activity level, the Western Ontario Shoulder Instability Index, the pain Visual Analogue Scale, the Oxford Shoulder Instability Score, the Constant Score and the Subjective Shoulder Instability Score, the Constant Score and the Subjective Shoulder Value scores.

Overall, there were 10 patients with re-dislocations in the Bankart group and 1 in the Latarjet group (p = 0.006). One of the Bankart patients and 5 of the Latarjet patients returned to their previous top level of competitive sports (p = 0.004) at follow-up.

In addition, there were no statistically significant differences between the two groups with it came to any of the other secondary outcome measures.

“Arthroscopic Bankart operation carries a significant risk for short-term postoperative re-dislocations compared with open Latarjet operation, in the treatment of traumatic anterior inferior instability in young males. Patients should be counselled accordingly before deciding the surgical treatment,” the researchers wrote.